Disseminated cryptococcosis with concomitant thoraco-abdominal involvement: a rare case report from india

Infections by Cryptococcus neoformans usually involves the central nervous system and the respiratory tract. We report a case of disseminated cryptococcosis with cryptococcal empyema and liver abscess. The initial diagnosis was only ascites with hepatitis and or cholangitis of unknown cause. Routine chest X-ray film showed pleural effusion, and his retropositive status was detected for the first time. Dissemination was considered when the computerized abdomen scans carried out revealed multiple cystic lesion of the liver with an abscess with diffuse peritoneal thickening. Culture of pleural fluid and liver abscess aspirate grew C. neoformans. Patient improved symptomatically with antifungal therapy. This case illustrates that disseminated cryptococcosis has to be included in the differential diagnosis in a systemic infection with thoraco-abdominal involvement, more so in an immunocompromised patient. Early diagnosis with relevant investigations like computerized tomography scans plays a key role in the administration of anti-fungal therapy which can be life saving.